BETA- BLOCKERS

• Beta blockers, also known as beta-adrenergic blocking agents, are medications that reduce blood pressure, it works by blocking the effects of the hormone epinephrine
(adrenaline) and Norepinephrine.
• Beta blockers cause the heart to beat more slowly and with less force, which lowers blood pressure. It helps to widen veins and arteries to improve blood flow.

BETA-RECEPTORS
Receptor Cites
B1 Heart
Kidney (JG cells)
Posterior Pituitary

Adipose tissue
B2 Lungs(Bronchioles)
Blood vessel,
Skeletal muscle
Liver muscle
Adipose tissue
Eye
B3 Fatty/Adipose Tissue

Classification of Beta blockers

Some beta blockers mainly affect the heart, while others affect both the heart and blood vessels.
Your doctor will choose which beta blocker is best for you based on your health conditions.
Non-Selective Blockers Selective Blockers Mixed Blockers
Non-selective, it targets both Beta 1 “selective”, because it only target the The mixed α-/β-
and Beta 2. Beta 1 receptor. blockers, carvedilol and labetalol, block
peripheral α1-receptors and both β1- and β2-
Have cardiac effect and on other Also called CARDIOSELECTIVE. receptors. These agents share the
system pharmacologic properties of nonselective β-
Example drugs here are metoprolol, blockers but have a lower degree of α-
Example drugs are timolol, atenolol and esmolol blockade than pure α-blockers, and their α-
oxprenolol, and nadolol blocking effects become attenuated with
chronic use.
Both Selective and non-selective Beta Blockers can produce cardiac effect because they both target Beta 1 receptors.
Drug Name Pharmacodynamics Pharmacokinetics Adverse Drug Reactions Dosage/Administration Indications/Contraindications
Timolol Mechanism: Nonselective Route: Oral, ophthalmic Bradycardia Oral: start with 10 mg Indications:
beta-blocker Absorption: well- Hypotension once daily, adjust as Hypertension
absorbed orally but for Bronchospasm (caution in needed Glaucoma (ocular use)
Blocks Beta-adrenergic ophthalmic (eye drop) asthma/COPD)
receptors use, the drug is absorbed Fatigue, dizziness Ophthalmic: apply 1 drop Contraindications:
through the eye’s surface Ocular in affected eye(s) twice Bradycardia
Reduces heart rate and bloodstream irritation(opthalmic daily Heart block
contractility Metabolism: primarily Asthma
metabolized in the liver Severe COPD
Lowers intraocular Elimination: through
pressure (IOP) by renal excretion, with a
decreasing aqueous small portion excreted in
humor production the feces.

Drug Name Pharmacodynamics Pharmacokinetics Adverse Drug Reaction Dosage/Administration Indications/Contraindications

Atenolol Mechanism: Selective Route: Oral Bradycardia Oral: in tablet form, the, Indications:
beta1-adrenergic Absorption: Its Hypotension Initial starting dose is at Hypertension
receptor blocker absorption is not Fatigue 20-50 mg qd Angina
significantly affected by Cold extremities Arrythmias
Reduces heart rate and food, so it can be taken Sleep disturbances Maximum dose: 100mg
contractility with or without meals Rare allergic reactions qd Contraindications:
Distribution: Atenolol has Bradycardia
Lowers blood pressure by a relatively short half-life Doctor may adjust the Asthma
decreasing cardiac output of about 6-7 hours. It dosages based on your Severe heart failure
does not extensively bind blood pressure
to plasma proteins which
mean it is mostly found in
the bloodstream rather
than being strongly
bound to proteins.
Metabolism: atenolol
undergoes minimal
hepatic (liver)
metabolism. It is
primarily excreted
unchanged in the urnine.
Elimination: primarily
eliminated through renal
(kidney) excretion. the
dosage of atenolol may
 need adjustment in
individuals with impaired
renal kidney function
prevent potential side
effects.

Drug Name Pharmacodynamics Pharmacokinetics Adverse Drug Reaction Dosage Indications/Contraindications

Carvedilol Mechanism: Non- Route: Oral Bradycardia Initial dose: 3.125mg Indications:
selective beta-blocker Absorption: the extent of Hypotension b.i.d. for heart failure Hypertension
and alpha-1 blocker absorption can be Dizziness, fatigue Heart failure
affected by food. It is Potential worsening of Hypertension: usual dose Post MI (myocardial
Reduces heart rate and well-absorbed form the heart failure symtppom 6.25mg to 25 mg b.i.d, infarction)
contractility GI tract after oral
administration. Dosage may be titrated Contraindications:
Dilates blood vessels , Distribution: it can cross based on response and Severe bradycardia
lowering blood pressure the blood brain barrier tolerance Heart block
and enter CNS Asthma/COPD
Used in heart failure to Elimination: Both renal
improve cardiac function and fecal excretion.